Category Archives: Soft Tissue Injuries

The Essentials to Stay Healthy While Traveling

Wakeboarding asks a lot of our bodies, but often times traveling to a competition can do more to your body than actually riding! Riding in a car or plane, eating out, and jet lag can take a toll on your body and affect your performance.

Here are a few ways to help combat the stressors of travel and increase your recovery for peak performance.

1. Drink water. Dehydration is the main component in the ill effects of travel. Air conditioning and heat in cars and planes dry out skin which is your biggest organ. Dehydration can lead to headaches, stiff muscles, joint aches, and poor immunity. The easiest way to prevent dehydration is by PRE-hydrating. The week before travel aim to drink a gallon daily. Bring an empty bottle to fill up after airport security and continue to drink water throughout your travels.

2. Bring tools. Lacrosse balls, tennis balls, rollers, and other mobility tools are helpful to decrease muscle tension and soreness while traveling. Many are small enough to put in your carry-on or backpack. While sitting, use the ball to massage back muscles, shoulders and glutes. Foam roll while waiting between flights or before getting into the car.

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Image: https://breakingmuscle.com/learn/the-4-best-self-myofascial-release-products-on-the-market

3. Stand up and stretch! Take breaks from sitting. Sitting is an unnatural position for our bodies leading to tightness in the hip flexors which ultimately leads to back pain. Walk around the plane during long flights, stop frequently during car rides and stretch out. The front body (chest, abdomen, hip flexors/quads) is the most compressed during travel so focus on opening this side rather than forward folding. Laying with your legs up the wall is also helpful to drain any swelling in the feet or ankles. You may look like a weirdo in the airport or plane, but your body will thank you!

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4. Wear compression. Compression tights are helpful during long flights or car rides to combat the swelling from sitting for long periods and changes in compartmental pressure. Swelling can make joints feel achy and decrease joint range of motion which will decrease performance. Compression can improve circulation and ultimately keep your legs feeling fresh during travel.

5. Pack your own food and take supplements. Airports and rest stop stations lack nutritional options for food so plan ahead! Pack healthy snacks, fruit, veggies and nuts to keep your diet well rounded. Fast food and sugar will decrease your immune system and increase your chance of getting sick!

Supplementation is always helpful to combat illness and aid muscle recovery.

-Vitamin C, B complex and Zinc can support immune function

-Glutamine, fish oil, and boswellia can aid in muscle recovery and inflammation reduction

Happy travels!!

 

 

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Benefits of Inversion

Its mid summer and wakeboarding is in full swing. This means lots of riding, progression, new tricks, and unfortunately, tired and sore bodies. One part of the body that gets taxed the most during wakeboarding is the spine. The spine is our center where most of the shock absorption occurs. The discs, which sit in between each of our vertebra, or back bones, are little cushions that help translate the pressure that happens when we jump, land,  twist, and bend. Keeping these discs healthy is important to avoid nerve injury, compression fractures to the spine, and disc bulging or herniation.

There are two very easy ways to keep discs healthy and continue riding safely and pain free. The first is simple has been written about before. Hydration. Drinking water hydrates the discs, making them taller and more supportive. Water also helps to keep the surrounding muscles, tendons and ligaments pliable and stretchy, which are good qualities of tissue to keep you injury free. Keep a bottle of water with you wherever you are: home, boat, cable, work etc. This will encourage you to drink more. Also, be sure to replenish lost water from sweat and exercise after riding and/or working out. Sun, wind, and sweating can dehydrate you quickly!

 

 

 

Handstand  Inversion Table

 

images: http://www.wholeliving.com and http://www.inversiontableanalysis.com

 

The second way to keep your discs healthy is inversion.  Inversion is the act of turning upside down in order to let gravity undo the daily pressures put on the spine. There are a few ways to invert, using a inversion table, which allows you to hang from your feet, or doing a head or handstand (freestanding or against a wall.) Both have astounding benefits for the body. These benefits include:

1. Natural decompression: Gravity pulls the spine in the opposite direction as our upright life, allowing for traction in the spine which increases the disc height, gives more space for the nerves and relieves pain. Not only does decompression help the spine, it also helps with hips, knees and ankles as well!

2. Posture correction and flexibility: Inversion stretches musculature and allows our bodies to elongate in the axial direction. This allows for misalignments in the spine to be corrected and slouching in the shoulders and middle back to be undone. Inversion keeps the muscles, tendons and ligaments flexible keeping joints healthy.

3. Circulation and Energy: Inversion allows for the heart to be above the head, causing a surge of circulation to the brain. This allows for increased energy, mental clarity and focus. The movement in the blood can cause a release in neurotransmitters causing an increase in mood as well. Increasing circulation also cleans the blood and moves lymph, helping with immunity.

Inversion can be done daily and should be held for 10-20 seconds upside down, then 10-20 seconds back at neutral (or right side up)  for a total of 10 minutes maximum. This allows for a pumping motion in the spine, causing the most nutrients, blood flow and hydration to return to the discs. Also, it is not necessary to be completely upside down. Many of the benefits of inversion can be received by moving the head below the heart, like in downward dog or shoulder stand, the yoga poses.

downward dog shoulder stand

 

 

 

 

 

images: http://www.the-yoga-connection.com and http://www.health.com

 

Note: Inversion is not for everyone. If you suffer from a heart condition, glaucoma, bone weakness, high blood pressure, ear infection, pregnancy, stroke, retinal detachment or significant spinal injury, inversion is contraindicated. Please consult a medical professional before trying inversion.

 

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Strengthening the Lower Back for Wakeboarding

backThe lower back is an extremely important area in the sport of wakeboarding. It acts as part of the core to stabilize while being pulled from either the boat or cable. It also is often engaged as the center of gravity for flips and spins. The lower back  is stocked with layers upon layers of muscles and ligaments for stability and cushioned with discs for shock absorption. The complexity is great, but often times, the small, but important,  muscles tend to be underutilized. It is important to keep them all engaged to prevent injury and remain pain free.

image: corpushumain.ca

Here are a few exercises to strengthen the stabilizing muscles in the lumbar spine:

1. Pelvic Tilts– Begin lying on the ground with your knees bent and feet flat on the floor. Start pulling your belly button into your spine and drawing it in and up. Hold for a few seconds then release, moving into an arched position. Repeat for 20 repetitions.

pelvic-tilt

image: ericavijay.net

2. Bridges– Begin in the same position as pelvic tilts. With your arms at your sides, palms facing down, push your pelvis up, contracting your glutes. Hold for a few seconds and lower back down to starting position. Repeat for 20 repetitions.

bridge-exercise

image: goldenworkoutroutines.com

3. Cross Crawl- Begin on your hands and knees, with your belly button pulled into your spine and your head in a neutral position. Start lifting right arm and left leg, extending out and elongating. Bring back to starting position and repeat with opposite arm and leg. Continue alternating for 20 reps per side, aiming to have a smooth transition and holding the abdominals tight.

lower_back-cross_crawl_kneeling2

image: humanhealthplace.com

4. Cat-Camel– Begin in the same position as cross crawls. Start by arching your back and sagging your belly (the cat). Hold for a few seconds and transition into pulling your stomach in as high as you can (the camel). Alternate back in forth for 20 repetitions.

catcamel

image: precisionsportsmedicine.com

5. Side Plank-Start in a push up position, except on the elbows. Move your weight to one elbow and open up to stack feet on one another or beside, depending on proficiency. Raise the free arm into the air or bend and place on hip. Hold for 30-45 seconds. Repeat on opposite side.

sideplank

image: womenshealthmag.com

6. Supermans- Begin lying on your stomach. Reach arms out overhead. Lift arms and legs a few inches off the ground and hold, while engaging the glutes and lower back muscles. Hold for 30-45 seconds. Repeat 3 times.

superman

image: fitnessandfreebies.com

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The Importance of Time Off: The Truth About Overtraining

We think there’s no possible way to over train in wakeboarding, right? The set is only 30 minutes long riding boat or an hour at the cable, so there is no way you can damage yourself by riding daily! WRONG.

The constant load on the body during wakeboarding can have some devastating effects.

overtrain

image: ausport.gov.au

How do you know you are overtraining?

1. You aren’t progressing, you are actually regressing. If you can no longer land the tricks you normally land, it takes more effort to do what was normally simple or routine, or if you feel sluggish with nothing to attribute it to (hang-over, heavy crosstraining, extended period off the water), you may be overtraining.

2. You feel restless, anxious, or have trouble sleeping. “When a power athlete overtrains, the sympathetic nervous system dominates. Symptoms include hyperexcitability, restlessness, and an inability to focus (especially on athletic performance), even while at rest or on your off day. Sleep is generally disturbed in sympathetic-dominant overtrained athletes, recovery slows, and the resting heart rate remains elevated. Simply put, the body is reacting to a chronically stressful situation by heightening the sympathetic stress system’s activity levels.”

Read more: http://www.marksdailyapple.com/overtraining/#ixzz2E1mdqgE0

3. Your muscles and joints hurt. Constant overuse can contribute to stress fractures, muscles strains, and an early onset of degeneration due to the constant forces on the body without any time for recovery. Muscles, especially, undergo Delayed Onset Muscle Soreness (DOMS), after an intense workout and may not show up until a few days after the initial workout, but can also be easily confused with improper training techniques or a microtrauma. It is important to differentiate the two, so any minor injuries can be given proper time and treatment to heal.

4. You are tired, have lost your appetite, lost muscle mass, and are irritable. Not a great combo, but are some tell-tale signs you’ve been training too hard.

So, what to do? 

Make sure you have at LEAST one day off completely. No activity.  Schedule cross-training and yoga/stretching/foam rolling so that the activity that requires the most effort (wakeboarding) is first, and the optional activities happen later. This will help prevent injuries caused by wakeboarding while  fatigued.

Listen to your body. If you are sore, in pain, fatigued etc. take the day off or commit to doing a lighter activity.

Use modalities like heat and ice, as well as proper nutrition and hydration to keep your body functioning at its highest potential. Massage, acupuncture, and chiropractic treatments are beneficial to help recovery times and aid in minor injuries.

Keep an eye out for warning signs to prevent any serious damage or injury.

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Rib Pain

Rib pain is nothing to mess with. Whether you fell on a rail, smacked the water, or feel pain from overuse, rib pain is something that is unforgettable. Pain around the ribs is very significant due to the inflamed intercostal nerves, which are very sensitive and run in between each rib. The pain can range from acute, stabbing, tearing pain, to a simple dull ache. Also between each rib is intercostal muscle as well as ligaments and tendons, which can be torn or pulled, also leading to pain on or around the rib cage.  The bones of the rib cage can break, from impact, which can lead to local pain directly over the region affected.

 

image: m-handbooks.blogspot.com

 

How do you know for sure you’ve injured your ribs? Look for:

1. Pain in the vicinity of the rib cage.

2. Bruising or swelling around the ribs.

3. Pain with pressure, contraction of the abdominal muscles, or deep inhalation.

4. Pain when stretching the rib cage area or twisting of the torso.

5. Pain that wraps around the chest and is band-like.

When to see a doctor:

1. If breathing becomes difficult or you experience any shortness of breath.

2. If you think you may have broken a rib.

3. Pain in a band that is accompanied by a rash.

What to do if you’ve injured your ribs:

Rest. Overusing the ribs or attempting to push through will only cause the injury to stick around longer. Take some time off and avoid re aggravation.

Ice. Icing the area for 15-20 minutes, multiple times per day will decrease local inflammation and reduce pain.

Take normal sized breaths. Avoiding full lung capacity will only increase the risk of lung infection, so try to breath normally, with occasional deep breaths, even if it is painful.

Protect the area. Be careful to avoid contact or activity that will further injure the ribs. KT taping is also helpful to temporarily support the ribs and surrounding tissues to speed healing.

Use massage or Graston/Gua Sha. These techniques can help to align torn fibers, reduce scar tissue and adhesion in the fascia, increase circulation, and speed healing.

 

The best way to help rib pain is to avoid injury or overuse in the first place! If trying new tricks or rails, wear a fully padded vest to ensure extra cushion in case of falls. Also, strengthening the muscles of the abdomen, back, and shoulders will secure the extra strength so the rib cage is protected. Happy Riding!

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Wakeboarding and Low Back Pain

Has wakeboarding given you low back pain? Unfortunately, the nature of falling from the sky onto flat water just isn’t ergonomically correct! Wakeboarding causes repetitive stresses to the tissue of the lower back, the vertebrae, discs, and muscles and ligaments that hold everything together. These tissues can cause pain that is local in nature, achy, and can turn into sharp or debilitating depending on how severe the damage is. What kind of pain are you having?

 

image:  www.necksolutions.com

Muscle

Muscle pain is typically the most common and is diffuse, or spread out, and is achy in nature. It comes about after lengthy rides, trying new tricks, multiple falls (that aren’t severe),  and typically feels worse after inactivity (like sitting) and better once you move around for a little while. Muscle pain can also be severe during the situation of muscle splinting or spasm. Muscle pain responds well to soft tissue treatments like massage, Graston, manual therapy, etc as well as icing techniques (15-20 minutes with small towel or shirt between ice and skin) and electrical stimulation to decrease inflammation or pain.

Vertebrae

Vertabrae are the bones of the spine that make up a column to act as the foundation of the midsection as well as protection for the spinal cord. Falls, repetitive stress, and the constant pounding from landings can cause the vertebra to shift and be come whats called subluxated. This is a malposition of the vertebrae which can cause pain and inflammation of the surrounding nerves. It can also cause decreased range of motion and over time, if not corrected, can lead to degeneration of the joint. Getting adjusted by a chiropractor or DO, stretching and yoga, and foam rolling can be useful in addressing pinched nerves and subluxations.

Disc

Between each of the above named vertebra are discs. Discs act as cushion for impact between the two bones. Discs can bulge or herniate if impact is great enough and cause significant pain due to the close proximity of the disc to spinal nerves. Pain from these nerves radiate, or originate at the spine but travel down an extremity. Disc pain can be treated through decompression, traction, adjustment, and therapies to reduce inflammation, like ice and electrical stimulation. This can all be done at a chiropractic office or physical therapist. If the disc issue doesn’t respond to conservative care, further evaluation should be done by a neurologist.

 

Lower back pain is  a very treatable condition when it comes to wakeboarding, and the best way to start is with ice and rest. Once the pain is under control, strengthening the lower spine will keep you from injuring it again in the future. More on that, coming next!

 

*If you have back pain accompanied by a fever, flank pain, abdominal pain, or bowel or bladder problems, consult your general practitioner to rule out the possibility of appendicitis, diverticulitis, kidney issues, or other organ pathology. If in doubt, always consult a physician. 

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Bindings, Landings, and Crashes: What to do about your ankle pain?

At some point or another, while wakeboarding, you may have experienced some ankle pain. It may have been while riding, after a landing, or something you have noticed later after you took your set.  You may have noticed swelling, tenderness, or an inability to bear weight on your foot. While riding, the ankle undergoes multiple forces that shear the bones and lead to inflammation. Bindings that don’t fit correctly, hard landings, or major crashes can cause the ankle to become injured.

Because the ankle attaches the lower leg to the foot, there is a complex network of muscles, tendons, ligaments, and bones involved.

    

image: medical-dictionary.thefreedictionary.com, http://home.comcast.net/~wnor/lljoints.htm

Bindings 

Typically, if your bindings don’t fit correctly, a pinching sensation will be felt in the front of the ankle. Because the binding is too tight around the metatarsals and forefoot, all the motion from leaning to stay on edge or landing must come from the joint between the talus and the tibia, instead of being able to translate through the foot . This “pinching” sensation is the bones putting pressure on the tendons and ligaments that cross the joint. Repetitive pinching can lead to inflammation and longer-lasting pain. Also, the lack of motion translated through the foot leads to a heavier heel stike on landings, cause heel pain after multiple tricks.

Landings

Landing hard, like into the flats or casing the wake, can lead to ankle injury. The force from the board hitting the water is dispersed through the joint , leading to pain that can manifest in a variety of areas. The pain will most likely be felt in the weakest part of the ankle,  which for most is the lateral, or outside, part. Because the ligaments in this area are the smallest, it is the most frequently sprained area of the foot. Making sure landings are absorbed with the knees, or are positioned correctly over the second wake will help prevent these injuries. If the injury has already occurred, proper treatment to resolve the injury is important so the ankle joint remains strong and doesn’t develop stress patterns and ongoing pain.

Crashes

The ankle is affected during many of the infamous wakeboard crashes. The worst seems to be the “foot came halfway out of the binding” crash. During this maneuver, the front of the ankle becomes stretched and the backside compresses. This overstretches the ligaments and muscles of the anterior ankle and pinches the calcaneous, of heel bone, into the talus and achilles tendon. This stretch and compression can lead to inflammation, swelling, and pain. Other crashes can cause the ankle to bend laterally depending on how you fall. This can lead to the more normal presentation of ankle sprain. Sometimes, however, the pain from crashes can be felt up the shin due to the design of bindings. It is important to treat the entire lower leg, below the knee, when the ankle is involved to ensure no causative factors are missed.

So what to do?

1. Make sure your bindings fit properly. Get advice from a representative or an employee of a local boardshop to make sure your bindings are the correct size and shape for your foot and your riding style.

2. Strengthen the ankles. Simple calf raises, toe and heel walks, and ankle ABC’s can do wonders to strengthen and prevent injury.

3. Treat injuries as soon as they happen. Remember RICE. Rest comes first. Don’t ride on a hurt ankle if you don’t have to. You will lead to further damage and possible stress fractures. Ice should be your best friend. 10-15 minutes 2 times per day will help calm inflammation and swelling, as well as numb your pain. Compression and Elevation will also help to reduce swelling.

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Shoulder Pain Part 2: How can you prevent it?

Preventing shoulder injury  is all about balance.  The balance comes between proper muscle strength and flexibility. It is important to be strong,mobile, and be able to accommodate to any condition or situation. Wakeboarding is a one-sided sport with dominance in both hand and foot. Balancing is the key to make sure you are riding long through this upcoming season and many more to come injury free!

Where to start: A training program designed to increase muscle strength while not sacrificing range of motion and flexibility.

What will help: Neuromuscular reeducation. Training your muscles to fire when needed, in proper sequence, to ensure each muscle works to its highest potential. This will include sport-specific exercises to engage and retrain the musculature.

Shoulder Strength Exercises:

1. Kettle Bell Swings- With a kettle bell or weight in hand, squat with kettlebell between legs. Swing the weight up as you stand and continue swinging until arms are overhead. Lower back down into a squat. Repeat. Make sure to maintain a tight core to protect the lower back.

Image: dk-workoutlog.blogspot.com

2. Wall Angels- Begin this exercises with your feet, buttocks, lowback, and neck/head all against the wall. Bring arms up overhead, while maintaining contact with the wall. Act as though you are doing a snow angel against the wall. The purpose of this exercises is to train the upper back and shoulders, while maintaining a neutral spine. For a demonstration, watch this video by Men’s Fitness UK.

Wall Angel Demo

3. Triplane Flying Pushups- Attach a full circle resistance band, like the Superflex band around a chin up bar or something of equal height. Attain a push up position with the band around your waist. Move from central, left, and right completing a full push up and exploding to the next position.  For added difficulty, add an incline or Bosu ball to the sides to vary the push up surface.

Thanks to Ned for introducing me to this exercise!

Neuromuscular Retraining

1. Handle Pass on Indo Board: Attach a handle to small weight. While maintaining balance on the Indo Board with knees slightly bent, begin to pass the handle. Continue around 15 times and then switch directions and repeat.

2. Resistance Band Handle Movements- This exercise will be varied depending on what tricks you are working on/towards. You can do these on solid ground or on an Indo Board. The purpose is to do handle movements against resistance which is anchored to mimic a line and handle. Doing repetitive motions mimicking tricks will help to build, not only shoulder strength, but muscle memory. For example, moving your arm in a crosswise fashion across your face and body to mimic a whirlybird, or pulling the resistance band to the middle of your back for landing blind. This will help to coordinate muscle movement while building strength.

Again, preventing shoulder injury is a fine balance between strength and flexibility. Train properly and you should remain injury free!

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Shoulder Pain Part 1: Why do you have it?

Why do you have shoulder pain?

The shoulder girdle is simply a shallow ball-in-socket joint. Because of the lack of depth in the socket, a vast and complex array of muscles, tendons, and ligaments act to stabilize the joint, holding your arm to your body but giving a wide range of motion at the joint.   Nine muscles cross the shoulder joint, and 17 attach to the shoulder blade! Because of the joint’s complexity, the chance of getting shoulder pain at sometime in your life is, unfortunately, pretty high.

Picture: tennismd.com

So what happens? Firstly, we are all “handed” creatures. Because of our dominance to one side, in life and in sport, its easy to develop muscle asymmetry.  When a muscle is overdeveloped, it works harder than the other surrounding muscles and can get fatigued, leaving you prone to injury and pain. The surrounding muscles also compensate for weaker ones, causing pain patterns. Secondly, we are also creatures of habit. We often do things repetitively. Working on a computer all day, texting, driving, wakeboarding… When activities become repetitive, wear and tear can develop in the tissues of the joint causing an overuse injury. This leads to the inflammation causing tendonitis, bursitis, and microtearing of muscles and tendons. Thirdly, we are involved in a sport that involves falling. Sometimes very hard. Trauma finds the shoulder like wakeboarders find glassy water. Fast. The shoulder is supported by a lot of muscles, but is often most weak compared to the other joints in the body. Trauma can tear muscles, tendons, ligaments, and cause separation or dislocation of the joints.

Finding out why you have shoulder pain generally takes looking into what you have in your history.  Questions like: Did you have any trauma growing up? What sports were you involved in? What other body parts have you injured? and What does your daily routine involve? can help give clues as to why you are having shoulder pain. A thorough examination of the tissues of the shoulder, including orthopedic and neurological testing can also be done, as well as imaging, to give the full picture.

Stay tuned: Next up is how to avoid getting shoulder pain and what you can do to help it if you already have it!

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To travel pain free, free the iliopsoas!

It’s holiday season and that means it is time for traveling! Whether its home for Thanksgiving, a snowboard trip out west, or just down the road for a get-together, a holiday pain free is one worth celebrating!

Most people have encountered a bout of low back, hip, or leg pain after a long road trip or a plane ride.  When traveling, we may attribute it to our heavy board bag and luggage or those god-awful seats in the airplane. Ironically, the pain that is experienced in the lower back, hip, or leg may actually be coming from your front side.

A muscle called the iliopsoas connects the front side of the lumbar vertebra (the bones in the low back that make up your spine) to the femur (the thigh bone). The muscle acts to flex the abdomen down to the thigh or to lift the thigh to the abdomen. This muscle is also referred to as a hip flexor. Because of the attachment to the spine, if the muscle is overcontracted, shortened, or spasmed, pain can be felt in the low back, hip, or leg. If the iliopsoas is contracted for a prolonged period of time, it can cause the glutes to fire improperly, tilt the pelvis forward, and jam the facet joints in the spine.

Image: http://www.themeanings.com

To prevent the psoas from ruining your holiday, here are a few helpful tips:

1. Move around. -The most common tip to travelers is to move around as much as possible. If in a car, take frequent gas/bathroom breaks to allow you to get out of the car and move around. If in the plane, try and get up at least once during the ride. Moving around will not only stretch the iliopsoas, but increase blood flow to the lower body.

2. Stretch. -To stretch the iliopsoas, kneel on one knee with the other foot in front with knee bent. Contract glutes and gently push foward, stretching the back hip flexor. Keep back straight and hold for 10-30 seconds. Repeat on opposite side. Be sure not to push front knee over front foot and keep a 90 degree bend in the front knee. To add additional stretch, raise arm overhead and reach away from side of stretch.

Image: www. sportsinjuryclinic.net

3. Activate the glutes. See post “Glutes Are The New Core”

4. Release the iliopsoas. The easiest way to have the iliopsoas released is to have a therapist or healthcare professional do it for you. If this is not available, find a ball, slightly larger than a tennis ball. Lie face down onto the ball, supporting your body with your elbows and feet. The ball should be positioned a little to the side and below the belly button. Continuously breathe and push your body into the ball for 10-30 seconds, releasing the trigger points in the muscle. The iliopsoas trigger points are very painful, so be sure to support your body with your elbows and toes to vary the depth of the therapy.

To travel pain free, free the iliopsoas. Happy Holidays!

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